Laryngoscopic evaluation with the Airway Cam® laryngoscopy video system

Purpose: The Airway Cam® is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam®. Methods: Twenty-seven patients receiving a general anesthetic for elective surgery had laryngoscopy performed by an anesthesiologist wearing the Airway Cam®. Each video was duplicated, then randomized and reviewed in a blinded fashion by the original laryngoscopist and a second anesthesiologist. Intra- and inter-observer correlations were identified. Results: There was good intra-observer agreement of the Cor mack-Lehane scale between direct laryngoscopy and laryngoscopy recorded with the Airway Cam® (κ = 0.63). The corresponding intra-observer correlation of the percentage of glottic opening score was strong at r = 0.83. There was good inter-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and that observed by the second anesthesiologist during Airway Cam® video review (κ = 0.70). There was moderate correlation of the inter-observer percentage of glottic opening scores (r = 0.73). Conclusion: This study validates that the view recorded by the Airway Cam® reflects the view of the laryngoscopist. The Airway Cam® may introduce an additional level of objectivity into airway management research and teaching.